Michael D Nissen, N.P.-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11026653 Issued in FL

Practice address

3399 Ferris Cir
Vernon, FL 32462-2217

Phone

(706) 594-6919

NPI assigned

Mar 30, 2007

Last updated

Nov 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

85.84 of 100Reported as group

Quality

79.14

Promoting interoperability

92

Improvement activities

40

Cost

80.32

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Firsthealth of the Carolinas, Inc.

  dba FirstHealth Montgomery Memorial Hospital Primary Care and Cardiology-Troy

  • Rural Health Clinic/Center
  • Troy, NC
  • NPI 1548276389
  Medicare reassignment NPD
• FHPG, LLC

  • Family Medicine Physician
  • Lillington, NC
  • NPI 1760329486
  Medicare reassignment
• FHPG, LLC

  dba FirstHealth Family Medicine-Raeford

  • Family Medicine Physician
  • Raeford, NC
  • NPI 1245335066
  NPD
• FHPG, LLC

  dba FirstHealth Family Medicine-Ellerbe

  • Family Medicine Physician
  • Ellerbe, NC
  • NPI 1336154129
  NPD
• FHPG, LLC

  dba FirstHealth Primary Care - Tramway

  • Family Medicine Physician
  • Sanford, NC
  • NPI 1942196035
  NPD
• Firsthealth of the Carolinas, Inc Dba Firsthealth Weight Management Clinic

  dba FirstHealth Weight Management Clinic

  • Obesity Medicine (Preventive Medicine) Physician
  • Pinehurst, NC
  • NPI 1316626104
  NPD
• Firsthealth of the Carolinas, Inc.

  dba Firsthealth Center for Rehabilitation - Pembroke

  • Physical Therapy Clinic/Center
  • Pembroke, NC
  • NPI 1457637704
  NPD
• Pancare of Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Panama City, FL
  • NPI 1033922984
  NPD (past)
• Pancare of Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Bristol, FL
  • NPI 1275346108
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1417077827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3399 FERRIS CIR",
            "city": "VERNON",
            "state": "FL",
            "postal_code": "324622217",
            "telephone_number": "706-594-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 FERRIS CIR",
            "city": "VERNON",
            "state": "FL",
            "postal_code": "324622217",
            "telephone_number": "706-594-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSEN",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "N.P.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "242756",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11026653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004922",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Jackson
• Kenneth L Jones, PA-C
• Erin Lynn Keip-Strausbaugh, LMHC
• L&S Home Health Care
• Jessica Lynn Mahaffey
• Northwest Florida Healthcare, Inc. (Vernon Clinic - Northwest Florida Community Hospital)
• Northwest Florida Healthcare, Inc. (Vernon Clinic-NFCH)
• Oak Valley Alf
• Samuel E Ward MD PL (Ward Medical Clinic)
• Vernon Discount Drug Inc

• Family Nurse Practitioner in Vernon, FL
• Providers in Vernon, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.